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  • Authorization To Request And/or Release Member ... - Hmsa.com

Get Authorization To Request And/or Release Member ... - Hmsa.com

SE SPECIFIED) Last Name First Name MI Address City State Email Home Phone # ( ) Cell Phone # ( ) Birth Date HMSA Subscriber Number(s) (Located on your membership card) ZIP Code / / PART B: REQUEST TYPE (Choose only one request per form) Request to Have HMSA Receive Information This allows HMSA to obtain information from the person or organization indicated in Part C of this form. Request to Have HMSA Send Information This allows HMSA to send copies of i.

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Follow the instructions below to fill out Hmsa cancellation form online quickly and easily: Log in to your account. Log in with your credentials or register a free account to test the service before choosing the subscription. Import a document. ... Edit Hmsa cancellation form. ... Get the Hmsa cancellation form completed.

You may request duplicate HMSA membership cards online. Just log on to My Account , hover over Profile, and click Request membership card. You'll receive a duplicate card within 10 business days.

If you have questions, email cws@hmsa.com or call HMSA's Consumer Web Support team at 1-800-720-1344 toll-free. If you email us, please include a phone number so our support team can call you back.

Preferred Provider Plan - A medical plan that combines the benefits of basic medical coverage and comprehensive major medical coverage in a single plan.

HMSA's Online Care virtual doctor app connects you to the best doctors on demand, from anywhere in Hawaii.

You can find out what plan you have simply by looking at your HMSA membership card. Consult your Guide to Benefits to find out what your plan covers.

The Hawaii Medical Service Association (HMSA) is a member of the Blue Cross Blue Shield Association, an association of independent medical insurance providers. A nonprofit, mutual benefit association founded in 1938, HMSA covers more than half of the state's population.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232